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Single anaesthesia techniques (IANB or BI) were not able to achieve pain-free emergency endodontic treatment. Supplemental anaesthetic techniques should be considered prior to treatment procedures in order to increase success rate (consort: registration number - NCT01912755/Fapesp: #2009/10834-4).

The aim of the present study was to evaluate and compare postoperative pain after foraminal instrumentation using 5.25% sodium hypochlorite (NaOCl) or 2% chlorhexidine (CHX) gel irrigation protocol in nonvital single-rooted teeth after reciprocating instrumentation. Sixty-two volunteers presenting a single root canal diagnosed with asymptomatic necrosis and apical periodontitis were randomized into 2 experimental groups regarding the irrigation protocol (ie, 5.25% NaOCl and 2% CHX gel groups). Endodontic treatment was performed in a single session under reciprocating instrumentation with foraminal instrumentation. Volunteers were instructed to record pain intensity. Scores from 1 to 4 were attributed to each kind of pain after 24, 48, and 72 h. Kolmogorov-Smirnov and Student´s t tests were used to determine significant differences at p<0.05. On average, the percentage of patients that had no or mild pain after 24, 48 or 72 h was 77.4%, 88.7% and 95.1%, respectively. No statistically significant age difference was found between the groups (p>0.05, Student´s t test). Postoperative pain showed no statistically significant difference at any observation period when using 5.25% NaOCl or 2% CHX gel (p>0.05). Moreover, no significant difference was observed in the mean number of analgesic tablets used between the groups (p>0.05). In conclusion, the use of 5.25% NaOCl or 2% CHX gel resulted in the same postoperative pain. Therefore, it can be inferred that irrigant choice has no relation with short-term follow up regarding postoperative pain. P o s t o p e r a t i v e P a i n a f t e r Foraminal Instrumentation with a R e c i p r o c a t i n g S y s t e m a n d Different Irrigating Solutions

<p><strong>Introduction: </strong>The aim of this case report is todemonstrate the retreatment of a maxillary caninediagnosed with a horizontal root fracture utilizingan electronic apex locator and monitored with conebeam computed tomography. <strong>Case Report: </strong>A 35year old African American male was referred for rootcanal retreatment of a maxillary right canine prior toprosthetic rehabilitation. Following removal of guttapercha, an apex locator was utilized to determine thelength of the root canal. After a more comprehensivedental history, the patient confirmed a previouslyunreported history of dental trauma at this time,leading to the suspicion of a horizontal root fracture.Clinical microscopy detected a connective tissue in theapical third of the root canal and multiple periapicaland occlusal radiographs enhanced visualizationof a horizontal root fracture. The coronal segmentwas filled with an MTA apical plug and the apicalsegment remained stable. A recall after 1.5 yearswas performed with CBCT, which showed no apicalradiolucency. <strong>Discussion: </strong>The present case reportreinforces the precept that detailed dental history andcareful observation of radiographs are critical factorsfor obtaining an accurate diagnosis. Fundamentaladjuncts, such as microscopy, apex locators andCBCT imaging, can potentially aid in the diagnosisand the subsequent treatment plan of horizontal rootfracture.</p><p>Keywords<br />Cone-beam computed tomography; Apex locator Cuspid; Radiography; horizontal root fracture.</p>

Este estudo teve como objetivo avaliar a eficácia anestésica da infiltração mandibular com articaína em primeiros molares inferiores através de 2 tipos de punções, utilizando-se de articaína 4% com epinefrina 1:100.000. Quinze voluntários saudáveis receberam 2 injeções realizadas em sessões diferentes. Uma única punção na região de vestíbulo do primeiro molar inferior e a segunda com 2 punções, sendo uma na região de vestíbulo do primeiro molar e outra na região do trígono retromolar. O pulp tester foi utilizado para verificar a eficácia anestésica. Escalas analógicas visuais determinaram a dor relatada pelo paciente. Concluiu-se que a infiltração de um tubete de articaína na vestibular de molares inferiores é mais eficaz que a divisão do tubetes e injeção no trígono. Ainda, há maior ocorrência de dor para a injeção na região do trígono durante a anestesia e após seu término.

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